{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T14:05:03Z","timestamp":1784642703124,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T00:00:00Z","timestamp":1731369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Pancreatic acinar cell carcinoma (pACC) is a rare malignancy with unique clinical and molecular features. The role of chemotherapy in pACC management is not well established.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The National Cancer Database (NCDB) for pACC was used. Cox regression was used in resected pACC patients to identify significant overall survival (OS) predictors. Patients were then divided based on these risk factors into propensity\u2010matched group of surgery versus surgery\u2009+\u2009chemotherapy and Kaplan\u2013Meier analysis was performed with log\u2010rank tests to compare OS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The NCDB 2004\u20132020 included 1592 pACC patients, 1553 were selected. Median age was 66 and 1090 (70.2%) were males. 622 (40.1%) received chemotherapy only, 257 (16.5%) had surgery only, and 365 (23.5%) had both. 189 Patients who received surgery were only matched to peers who had surgery\u2009+\u2009chemotherapy. The median OS for surgery only was 57.8\u2009\u00b1\u20096.0 versus 54.2\u2009\u00b1\u20099.9 months for surgery\u2009+\u2009chemotherapy (<jats:italic>p<\/jats:italic>\u2009=\u20090.836). Cox regression identified nodal and margin status as independent predictors of OS. Therefore, subgroups of patients with node\u2010negative, node\u2010positive, margin\u2010negative, and margin\u2010positive resections were similarly matched 1:1 for the receipt of surgery only versus surgery\u2009+\u2009chemotherapy. Only patients with node\u2010positive disease had a significant OS benefit with the addition of chemotherapy (44.2\u2009\u00b1\u20097.3 vs. 27.5\u2009\u00b1\u200910.5 months; <jats:italic>p<\/jats:italic>\u2009=\u20090.036).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our analysis suggests that surgical resection remains the cornerstone of therapy for pACC. Node status and margin status are the primary prognosticators. The addition of chemotherapy provides an OS benefit only in node\u2010positive disease.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.27834","type":"journal-article","created":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T12:22:01Z","timestamp":1731500521000},"page":"1624-1633","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The role of chemotherapy in the management of pancreatic acinar cell carcinoma"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4601-1309","authenticated-orcid":false,"given":"Kimberly P.","family":"Woo","sequence":"first","affiliation":[{"name":"Department of General Surgery, Digestive Disease Institute Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9275-4744","authenticated-orcid":false,"given":"Chase J.","family":"Wehrle","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Digestive Disease Institute Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daphne","family":"Remulla","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Digestive Disease Institute Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny H.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Digestive Disease Institute Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Naples","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Digestive Disease Institute Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Joyce","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Digestive Disease Institute Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Digestive Disease Institute Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toms","family":"Augustin","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Digestive Disease Institute Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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